Hospitalisation, hospital discharge and duration of hospital stay
In a pooled analysis of eight and three studies, there was no signification association between hospitalisation, hospital discharge rate and ACEIs/ARBs (OR: 1.15; 95%CI: 0.81, 1.65; OR: 1.21; 95%CI: 0.74, 1.99), ACEIs (OR: 1.08; 95%CI: 0.79, 1.46) or ARBs (OR: 0.91; 95%CI: 0.74, 1.11) (Figure 7; Figure 8Table 3). However, sub-group analyses demonstrated a significantly higher risk of hospitalisation with ACEIs/ARBs among studies conducted in the USA (OR:1.59; 95%CI: 1.03, 2.44), peer-reviewed studies (OR:1.93, 95%CI: 1.38, 2.71), good quality studies and studies which reported adjusted measure of effect (OR:1.30, 95%CI: 1.10, 1.50) (Supplementary file 7; Table 4). Contrastingly, a significantly higher rate of hospital discharge was observed with ACEIs/ARBs but only among non-peer reviewed articles (OR:1.51; 95%CI: 1.18, 1.93) (Supplementary file 8; Table 4). Two studies reported data on the duration of hospital stay. Both were in favour of ACEIs/ARBs with Yang G. et al (25) reporting a significant reduction in the mean duration of hospital stay of 2.3 days (95%CI: -3.61, -0.99) with ACEIs/ARBs whilst Zeng et al (26) reporting a lower median duration of hospital stay of 21 days (IRQ: 15-25) with ACEIs/ARBs versus 22 days (IQR: 16-28) with non-ACEI/ARB use.